Health Insurance Plan Selection Consent


Thank you for filling out our consent to enroll form.  We now have authorization to make changes to your marketplace account and assist you in making a plan selection. We greatly appreciate your trust in our services and the consent you've provided for us to select and enroll you in the best plan available in your zip code. This is available to clients who are eligible to receive a zero premium CSR type plan.


We want to reiterate our commitment to providing personalized assistance tailored to your unique needs. We understand that some clients have no specific health concerns or prescription requirements, and for them, the plan we suggest based on having the lowest premium and comprehensive coverage is often the ideal choice.


Here's what you can expect:

  1. You'll receive an email containing a Summary of Benefits that comprehensively outlines your chosen plan's coverage details. This will be sent to the email address on file.
  2. This email will also contain all our contact information, making it easy for you to reach out to SHL with any questions or concerns that may arise. Your peace of mind is essential to us.
  3. If, upon reviewing the plan details, you decide that another option better suits your needs, you'll have the opportunity to change your plan. We are here to assist you throughout this process.
  4. For those clients who do not already have an account with the Federal Market place a brief phone call will be required to complete enrollments.


At SHL, our goal is to ensure you have the most suitable health plan and a seamless experience. Your well-being is our top priority. If you ever require assistance or wish to explore different options, please don't hesitate to reach out. We're here to support you.

Thank you for choosing Senior Health and Life as your agency of record. We're proud to be your trusted partner in navigating the complexities of healthcare.



Name of Primary Writing Agent: Anton Gonch

Agent National Producer Number: 19952273

Phone Number: 860-281-7569

Email Address: anton@shl.agency


Consent Form